In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The US Agency for International Development announced the launch of its second request for applications for its ‘Saving Lives at Birth: A Grand Challenge for Development’ program, which calls for innovation prevention and treatment approaches for pregnant woman and children in developing countries. The Centers for Disease Control and Prevention discusses its role in global HIV and tuberculosis research and development (R&D) with Science Speaks. Medicines for Malaria Venture announced more than 100 million child-friendly malaria treatments have been delivered to 30 malaria-endemic countries since 2009. The announcement represents a key success story in global health R&D OneWorld Health’s treatment for leishmaniasis is now registered for use in Nepal.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. President Obama releases his fiscal year 2013 budget with mixed reviews for global health research and development. The Centers for Disease Control and Prevention is making headway in tuberculosis research in Kenya. New ways of preserving vaccines are about to enter field trails in Vietnam. This technology could be used around the world. Data sharing can be the catalyst to more research and development for neglected tropical diseases. Scientists show how some cells in the body can repel attacks from HIV.

Nick Taylor is the program assistant at the GHTC. On Wednesday, he attended a briefing on Capitol Hill hosted by the Office of the Global AIDS Coordinator. Wednesday’s briefing—co-hosted by the Foundation for AIDS Research (amfAR), the President’s Emergency Plan for AIDS Relief (PEPFAR), and the Center for Global Health Policy at the Infectious Diseases Society of America —convened several HIV physicians and scientists to discuss PEPFAR and the evidence-based HIV prevention methods that the program implements in countries with high rates of HIV and AIDS. This briefing was the first in a series that will be held leading up to the International AIDS Conference this summer in Washington, DC. For thirty years, HIV and AIDS have proven to be among the most difficult public health threats the world has ever seen. While there have been many successes in combating HIV in recent years, most recognize that there is still a lot more to be done in order to achieve the goal of an AIDS-free generation. On Wednesday, members of the HIV and AIDS community gathered in the Kennedy Caucus Room in Washington, DC, for a briefing on PEPFAR and combination prevention treatments. Panelists stressed the importance of research and development (R&D) in the fight against AIDS and noted the successes of PEPFAR in expanding access to HIV and AIDS prevention. Last year, the world watched as President Obama said that “we can end this pandemic” and Secretary of State Hillary Clinton declared that we can get the number of mother-to-child transmissions of HIV to near zero by 2015. These powerful statements—along with the International AIDS Conference occurring in Washington, DC, this year—have put a renewed focus on innovation and research for preventing and treating HIV. Dr. Diane Havlir—a professor of medicine at the University of California, San Francisco, and panelist at Wednesday’s briefing—stated that investing in research allowed scientists to determine how to treat HIV with antiretroviral treatment (ART), which has saved millions of lives. In fact, according to Dr. Havlir, because ART has helped to keep people healthier, many societies have saved significant funds that would otherwise have been spent on medical care. This is surely a sound economic incentive to invest in research more often. Research and innovation need to play a key role in the global effort to achieve an AIDS-free generation. Photo: Evelyn Hockstein/PATH.. The briefing highlighted some of the most recent innovations that have been developed to prevent HIV. There is no question that ART has been successful in treating people infected with HIV, but studies have also shown that we can use treatment as prevention for HIV as well. If patients are put on ART at an earlier time than is normally recommended, the transmission rate from one HIV-positive person to a HIV-negative person can be reduced by more than 90 percent. Medical male circumcision has also proven to be an extremely effective way of preventing the spread of HIV. PEPFAR alone has provided funding for over four million male circumcisions since its inception, and panelists reported that the cost savings of those and the millions of circumcisions funded by nongovernmental organizations and other government programs has been nearly $16 billion. There are new tools in the pipeline that are making male circumcision faster, cheaper, and most importantly, safer. These devices require no anesthetic, no sutures, and do not need to occur in a sterile setting—which is often too hard to find for many men. This July, when the International AIDS Conference convenes, all eyes will be on Washington. Much will be said about the pandemic, and grand declarations will surely be made. What we’re all hoping to hear is that research and innovation will play a key role in fighting, and eventually ending, the HIV and AIDS pandemic.

Center for Global Development (CGD), a Washington DC-based think-tank that works to reduce global poverty and inequality through research, officially released its newest report on global health earlier this week. The launch brought together donors, academics, public health officials, and representatives from the pharmaceutical industry to continue an important conversation about improving one of the biggest challenges in global health: bringing the best health tools that research has to offer to the people who need them most through improved regulatory pathways. The report, called Safer, Faster, Cheaper: Improving Clinical Trials and Regulatory Pathways to Fight Neglected Disease, outlines a two-pronged approach—establishing regional regulatory pathways for the oversight of clinical trials, and building quality and cost-efficiency into trial planning and design. The report was the product of a working group that included representatives from donor groups, philanthropy groups, product development partnerships (PDPs), consulting firms, the pharmaceutical industry, government, researchers, and developing and developed country regulators. New report from Center for Global Development highlights need to improve regulatory pathways to help deliver health tools to the people who need them the most. Photo Credit: Satvir Malhotra Working group chair Tom Bollyky from the Center on Foreign Relations noted that navigating through even a single regulatory pathway can often be the most challenging part of bringing new products to market. Yet, many global health product developers find themselves needing to navigate not one but several regulatory pathways, often overseen by authorities with severely limited capacity, making the process seem insurmountable. According to the working group, a unified approach to approving and overseeing clinical trials could dramatically speed up product development and delivery. CGD’s report proposes “a centralized procedure model in which participating regulatory bodies and ethics committees jointly approve and oversee clinical trials for neglected disease technologies.” Additionally, the working group proposed that changes be made with clinical trials themselves—specifically the way they are organized and financed. Clinical trials are often modeled off of previous, successful clinical trials, most of which occur in wealthy countries. As a result, trial protocols have become extremely complex and expensive to carry out, putting them out of reach for developing countries where, too often, resources are sparse. Further, the working group recommends more input from local investigators and independent stakeholders early on in the clinical trial design. Food and Drug Administration (FDA) Commissioner Margaret Hamburg highlighted the need for new ideas and processes to advance global health technologies and regulatory pathways in her keynote address. In speaking of the FDA’s interest in the new report, she told that audience that failing to address the needs of the developing world’s health concerns undermines the health, security, and wellbeing of us all. She added that now, more than ever, global diseases need global solutions.